无症状性脑梗死对首发急性脑卒中患者预后的影响分析

Effect of asymptomatic cerebral infarction on starting the prognosis of acute stroke patients analysis

目的：探讨无症状性脑梗死对首发急性脑卒中患者预后的影响。方法：选择2010年6月～2012年6月在我院接受治疗的135例急性脑卒中患者，按照 MRI 检查是否伴有无症状脑梗死将患者分为无症状性脑梗死（SCI）组与非无症状性脑梗死（非 SCI）组，其中 SCI 组62例，非 SCI 组73例，采用蒙特利尔认知评估量表（MoCA）及简明智力状态检查量表（MMSE）分别对两组患者发生脑卒中2周及3个月进行认知功能评定，并对两组患者肢体活动能力及3年内复发率、死亡率进行统计比较。结果：SCI 组与非 SCI 组两周及3个月 VCIND、VD 比较差异具有统计学意义。脑卒中3个月后两组患者认知功能损害均有不同程度的下降，但所占比例仍较高。虽然非 SCI 组两周及三个月 VCIND 发生率较 SCI 组高，但 SCI 组两周及三个月显示出更高的 VD 趋势。与卒中后2周比较，非SCI 组患者总体认知功能显著改善，视空间执行功能、注意力和抽象思维能力显著改善，比较差异具有统计学意义；而 SCI 组与两周时比较，卒中后3个月 SCI 组总体认知功能及视空间执行功能、注意力和抽象思维能力无显著改善，无统计学意义。SCI 组不能抬起上肢、不能独立行走及3年内脑梗死复发率、3年内死亡率均显著高于非 SCI组，比较差异具有统计学意义。结论：无症状性脑梗死对首发急性脑卒中患者显示出更高的 VD 趋势，会进一步加重脑卒中患者认知的损害，并且具有较高的致残率、脑梗死复发率及死亡率。在临床上应重视对 SCI 的诊断，并使患者对 SCI的危害得到充分的认识，积极的采取针对性的措施，以预防脑卒中的发生。

Objective To investigate the effect of acute episode of asymptomatic cerebral infarction prognosis of stroke patients. Methods June 2010~2012 in June in our hospital treated 135 cases of acute stroke patients, according to MRI, is as-sociated with asymptomatic cerebral infarction patients were divided into asymptomatic cerebral infarction (SCI) group and non- asymptomatic cerebral infarction (non SCI) group, which SCI group of 62 cases, 73 cases of non-SCI group, using the Montreal Cognitive Assessment (MoCA) and concise mental State Examination (MMSE) were two groups of patients with brain occur stroke two weeks and three months cognitive function assessment, and physical activity two groups of patients and the recurrence rate within three years, the mortality rate for statistical comparisons. Results SCI group and non-SCI group, two weeks and three months VCIND, VD and the difference was statistically significant . Stroke three months after the two groups of patients have varying degrees of cognitive impairment declined, but the proportion is still high. Although the non-SCI group two weeks and three months, compared with the incidence of SCI group VCIND high, but two weeks and three months SCI group showed higher VD trend. Compared with the two weeks after stroke, overall cognitive function in patients with non-SCI group signifi-cantly improved visuospatial executive function, attention and abstract thinking ability improved significantly, the difference was statistically significant; and SCI group and two weeks comparison, three months after stroke SCI group overall cognitive function and visuospatial executive function, attention and abstract thinking no significant improvement was not statistically significant. SCI group can not lift the upper limbs, can not walk independently and cerebral infarction recurrence rate within three years, three years, the mortality rate was significantly higher than non-SCI group, the difference was statistically significant. Conclu-sion Asymptomatic cerebral infarction on starting acute stroke patients showed higher VD trends will further increase awareness of the damage in patients with stroke, and has a high morbidity, recurrence rate of cerebral infarction and mortality. In clinical diagnosis should pay attention to SCI, and SCI patient harm have been fully recognized and active take appropriate measures to prevent the occurrence of stroke.